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Pediatric En-Bloc: The Smallest Kidneys

Children usually have healthy, pristine kidneys. Unlike many adults, babies and children haven’t lived long enough to develop high blood pressure, diabetes or complicating exposures.

UVA kidney transplant surgeons have expertise in transplanting kidneys from infants. This very unique procedure helps us save as many lives as possible and make the best out of heartbreaking loss.

Since most transplant centers do not offer this option, we receive these kidneys from all over the country that would otherwise be thrown away.

The Challenge of Tiny Kidneys

The small size of infant kidneys poses a number of challenges for organ transplantation. They’re so small, they’re:

Unable to clean the larger bodies of adults

Technically challenging to surgeons, because of the tiny blood vessels

At higher risk for clotting in immediate posttransplant period (and a blood clot destroys the kidney)

The smaller the kidney, the higher the risk and harder the procedure. Due to these obstacles, most transplant centers do not transplant infant kidneys.

The En-Bloc Procedure & Its Benefits

At UVA, we’ve adopted the “en-bloc” approach to allow us to transplant these small kidneys. Instead of transplanting a single kidney, we keep both of the kidneys attached to the aorta and vena cava and attach the entire “tree” — the two kidneys, the aorta and vena cava, sewn over at one end — onto the recipient.

Our surgeons have developed the precision and skill to perform and perfect this procedure. And our highly selective process for choosing the organ recipient allows us to give the transplant every chance to succeed.

Advantages of the En-Bloc Procedure

While the infant kidneys start off very small, they will grow with you. Eventually, the recipient will have two adult kidneys that have never seen disease.

With traditional kidney transplant, the donated kidney degrades due to the wear and tear of time and use. With the en-bloc transplant, kidney function actually improves over time.